IJOH Vol.11 No. 1 (January-June) Article - 6
Review Article
International Journal of One Health, 11(1): 62-77
https://doi.org/10.14202/IJOH.2025.62-77
Legionnaires’ disease: A review of emerging public health threats
2. Research Center for Pharmaceutical Ingredients and Traditional Medicine, National Research and Innovation Agency, Jl. Raya Bogor, Km. 46 Cibinong, Bogor, 16911, West Java, Indonesia.
3. Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Jl. Raya Bogor, Km. 46 Cibinong, Bogor, 16911, West Java, Indonesia.
4. Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakaliki, 480211, Nigeria.
5. Research Center for Public Health and Nutrition, National Research and Innovation Agency, Jl. Raya Bogor, Km. 46 Cibinong, Bogor, 16911, West Java, Indonesia.
6. Research Center for Preclinical and Clinical Medicine, National Research and Innovation Agency, Jl. Raya Bogor, Km. 46 Cibinong, Bogor, 16911, West Java, Indonesia.
Background and Aim: Legionnaires’ disease (LD), caused by the Gram-negative bacterium Legionella pneumophila, has emerged as a significant public health concern due to its rising incidence and high morbidity and mortality rates. This review comprehensively examines the etiology, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prevention of LD. The bacterium thrives in aquatic environments, often within biofilms and protozoan hosts, contributing to its resilience and widespread distribution in natural and man-made water systems. Transmission primarily occurs through the inhalation of contaminated aerosols, with immunocompromised individuals, the elderly, and smokers being at heightened risk. Clinically, LD presents as a severe pneumonia with systemic involvement, and its diagnosis often relies on culture, urinary antigen tests, and molecular methods. The treatment landscape is dominated by macrolides and fluoroquinolones, with emerging research into alternative therapies to combat antimicrobial resistance. Effective public health strategies, including rigorous water management practices and infection control measures, are vital in mitigating the risk of outbreaks. This review aims to enhance clinical awareness and inform public health initiatives by elucidating the complex interplay between bacterial virulence, host factors, and environmental conditions that contribute to LD transmission and persistence. A better understanding of these dynamics is crucial for developing robust prevention and control strategies, ultimately reducing the global burden of this potentially life-threatening disease.
Keywords: Legionella pneumophila, Legionnaires’ disease, pneumonia, public health, waterborne pathogens.
How to cite this article: Khairullah AR, Nuradji H, Nurjanah D, Dharmayanti NLPI, Wardhani BWK, Wibowo S, Moses IB, Kurniasih DAA, Fauziah I, Kusala MKJ, and Fauzia KA (2025) Legionnaires’ disease: A review of emerging public health threats, Int. J. One Health, 11(1): 62-77.
Received: 23-09-2024 Accepted: 07-02-2025 Published online: 30-03-2025
Corresponding author: E-mail:
DOI: 10.14202/IJOH.2025.62-77
Copyright: Khairullah, et al. This article is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/ by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
